SPRING AND AGM

Here in Scotland Spring has arrived and with it for us very good news to set us up for the year. We have been awarded a grant by the Scottish Government Small Grant scheme to consolidate the work in Zambia this year. We couldn't be more pleased and at our AGM yesterday confirmed the plans for the next 12 months.
We have heard from the three trainee trainers in Lusaka and they have been working on the training materials to ensure they are contextually relevant. This work will be continued with Lesley when she goes out at the end of May to do the groundwork for our cooperation with SCHEME and for the ZTA Course delivery in other Provinces which is due to take place in September and October.
Here we are continuing to spread the word about the training and share what we have learnt from the responses of trainees and patients that we think is really important learning for the use of art in health contexts and the practice of Art Therapy.
Anyway we are all very optimistic about the work though a bit overwhelmed about all there is to do- very exciting!

FINISHING UP AND MOVING ON

Last Chainama group

So these are the last days of this trip. As always the last sessions are fascinating with the evaluations of the training by the trainees and the assessments. We used a simpler evaluation process this year with a view to its being more replicable. The trainees used post its to make responses to a series of questions about what changes there might have been for them over the training. Interesting responses and discussion - the main outcomes being positive changes in communication, observation and interpersonal skills as well as powerful reflections on the value of art making for them and their patients.


With the assessments safely out of the way we shared the marking with the ToT trainees for their learning of the process. Then came the really stressful bit that I had been left with - writing everyone's names neatly and accurately on the Certificates! This done they have all been safely delivered for presentation, a very satisfactory set of outcomes.

ToT trainees

The outcomes of the trainings have been reported to the Institutions and plans confirmed for the next steps. It has been great to get such positive feed back and enthusiasm for maintaining the practice.
I met with the three ToT trainees to check out their feelings about what they have learned in stage 1 of the training and to consolidate the next stages and what we have to do together to refine and adapt the contents of the manual.

Clay work made by a trainee after discussion of the value of group work

For me this clay piece says so much about the process and what we have all learned from each other

Looking back at my first time in Zambia

It's always sunny in Zambia!

I have been looking at some of the photos I took in Zambia and realising what a partial view they offer. As I was going through them, I kept thinking “if only I had a shot of that view” or “it didn’t look like that at all” or ‘why didn’t I get that”. That’s the nature of a short visit; you think you’re seeing a lot but there are so many gaps in the view and you have to beware of making judgements based on such a limited experience. Zambia presented me with equal measures of stimuli and confusion so it could be easy to leap to mistaken conclusions.

Where are we going today?

 Much of my time at the beginning was spent in trying to sort out what was happening, attempting to understand what people were saying and not knowing where I was or where I was going. Like any new place, it took a while to orient myself. This was my first experience of working in a developing country and had I not been able to work alongside two experienced trainers, Lesley and Joanna, I would have been completely lost. The people I met were unfailingly courteous and helpful but I struggled to follow conversations and to pick up the keys to what was being said. Although the official language is English, Zambians also use many other languages and often used Nyanga, Bemba or another local language as well. The subtleties of gesture and non-verbal communication in Zambia meant I must often have missed something or, worse, just appeared plain rude.

Maybe Google knows where I am....

The teaching sessions were accordingly difficult at first but gradually began to make a comprehensible pattern and it became apparent that the course we delivered really did offer a useful toolkit for the Zambian mental health workers who took part. Now that Zambian ethical approval has been obtained to conduct an evaluation of the work, it will be possible to gather data and information about the impact we are having and to test out the outcomes of the training more rigorously. Health systems in Zambia are very different to those I am used to in Scotland and evaluating what we do is correspondingly more challenging but equally important.

It has been good to find out that the skills and knowledge I had acquired over my years of practice in Scotland were valid and useful in Zambia and could be shared with workers there. I still feel that I have only just begun to understand the differences and similarities in Zambia and in the Zambian health system compared to Scotland, and I have a lot more to learn. It was good to come back to Scotland and find that the Scottish Government is focusing on Zambia as one of its partners for international development work and will announce a new funding initiative in early March 2017. ZTA will hopefully be able to get involved in this new strand of work and to continue its contribution to mental health systems in Zambia.

 Simon

TIME RUSHING BY

The last couple of weeks always seem to come upon us in a rush. To start with there seems to be plenty of time to get everything done and where does it go!
Both training programmes are virtually ended now - so making sure all the course content has been covered has been a major concern. In both training sites the quality of the discussion has been great with people really trying to work out how within the very real constraints of resources and structures they can carry on using this approach.
Lesley has finally got Ethical approval for the use of trainee data for analysis, quite a marathon - it is a very rigorous process.
We had an encouraging meeting at the Ministry of Health and it does seem as though the roll out of Training of Trainers will be supported as far as possible by the Institutions, the Districts and the Ministry. We have made good progress with the ToT trainees at reviewing what we have offered them and clarifying the requirements for the future and for the next stage. Also good progress in structuring the course contents.
Sylvester and Pierre from MHUNZA organised a meeting of their members to reflect on the possible use of a Well Being measure. To check its relevance and language and the feedback has been very useful, Two of the ToT trainees attended that meeting and we will hear from them on Monday. This is something that might be useful in the future as part of getting service user responses to therapeutic art  practice and we are grateful for their help with this.
Tomorrow we start the evaluations and assessments and introduce the ToT trainees to this part of the process. Lesley leaves on Thursday and I will be finishing the assessments and holding feedback meetings to keep people updated.
We have just had three days without rain but earlier in the week there continued to be really heavy downpours every day, driving is a real skill in these conditions and the patience and courtesy shown by Zambian drivers is a lesson to many of us!

TAKING STOCK

The week has rushed past and Lesley and Simon are back  from Chipata-they got a 5.0 am bus  (7 hour journey) and actually managed to arrive  by in time to join us at the Dutch Reform Church monthly Market yesterday and enjoy the array of wonderful things to buy. I have to say I have set myself a few packing issues for the return journey! They were even up for an evening at Modzi Arts listening to 70s Zambian music - some stamina.





The training has again been full of surprises and the trainees  have used their wide experience to enrich the learning for us all. We have been using role play a bit more in some of the experiential art work and this has proved very fruitful for all.

 As we are working with the ToT ( Training of Trainers) trainees we have had to apply more detailed attention to structuring the content of the training and this has proved to be a very valuable exercise but it has also been reassuring in that it seems as though it will be possible to produce a model that can be replicated without becoming too rigidly manualised.
We are getting to the stage  in this trip when we have to start arranging all the meetings and feedback sessions to report to the Institutions and the Ministry so that planning for the next developments can start. The endings always seem to come in a rush.
Lesley has changed her return flight so she will be here to help with most of the evaluation and assessments. These again we have adapted in light of experience and in planning how it can be most effective in different settings.
We sadly say goodbye to Simon this week as he is off back to the Scottish winter. I am sure he will be posting about his impressions but another head and pair of hands has been a great asset.

WELL INTO TRAINING

So another week over. It goes so fast! We have had two weeks full training at both UTH and Chainama and continue to be completely absorbed by the directness of the responses to the training both from trainees and the patients who attend in Chainama. Simon as a newcomer has shown great resilience and taken over bits of training,spent a long time reconstituting the raw clay provided for us by one of the trainees and generally keeping Lesley and I focused.  

The three people who have joined us in the Training of Trainers piloting have already contributed ideas and responses. This included a wonderful energiser exercise which had the whole UTH group and trainers moving round in a circle rhythmically chanting and having to incorporate spelling our name when picked on. There have been days when the rain has been heavy and prolonged in a way completely different from at home, Simon - who despite advice - did not bring an umbrella very nearly didn't get any breakfast as it was too heavy to get from his room to our house! One training group at Chainama managed to get to the OT building but it would have been impossible to get patients across so the morning was spent very productively in art exercises, reflection and case sharing. Lesley has been gallantly working on the revisions required by the Ethics body and got them submitted - hopefully we will hear on Monday - this for using the feedback data from trainees for analysis and publication. Apart from work we have had an evening in a bar listening to music from a friend's band - great sounds! - a meal with another friend at the wonderful Lebanese restaurant nearby and last Sunday we went out of town a way and saw the orphaned baby elephants at the David Shepherd rescue park. They are entrancing and the long process of re-wilding them once they are fit is impressive. so we are managing our work life balance. Next week Lesley has some work in Chipata and it seemed a good opportunity for Simon to see something of the country - so they are off on the bus on tuesday and Simon is going to spend a night at South Luanga Park. Meanwhile I am left running the training! with the help of the 3 ToT trainees, actually midway through as we are the routine and course content is quite well established. But time will tell. A postscript - I started posting this blog on Friday, only now has the internet connection allowed it!

One week in.

And quite a week! It has been really good meeting again so many people, friends from before and new people interested in what we are doing and wanting to join in. Meeting the new trainees both at UTH and at Chainama Hospital is always fascinating. They are so prepared to share their responses and experience and we learn so much from them.
We are working with three great ex trainees who are shadowing us this year to help us look at how the first stage of Training of Trainers can be shaped and already in the first week they have contributed new ideas.
The OT department at Chainama is familiar territory now and we were made welcome and furniture and the technology was all provided. It was great during our first practical session with patients to see 19 people all working completely silently absorbed in their art making.
Today we have met again with MHUNZA and ZAFOD, two key psycho-social, intellectual and physical disabilities rights organisations to learn more about their current work and update them on our plans.
Life at Gossner continues to be peaceful and refreshing. I have not been here before when everything has been so green and lush - it is all very different from the baking heat of my last visit. I am writing this listening to the steady fall of rain on the veranda and dripping off the leaves.
We have managed to feed and entertain ourselves after work but I think I speak for all of us when I say this first week though productive and encouraging has left us pretty tired every evening.